Houston Cataract Surgeon Bernard Milstein, M.D. explained about correcting astigmatism after cataract surgery with toric lens implants. “Most cataract patients know from their eye exams or eyeglass prescriptions that they have some amount of astigmatism. However, sometimes they don’t realize that it is important for their cataract surgeon to correct that astigmatism in order to get the best visual results after cataract surgery,” explained Dr. Milstein of The Eye Clinic of Texas serving greater Houston & Galveston, TX.

BernardAMilsteinMDphotoAstigmatism is a common refractive eye condition that that is most often due to an uneven curvature of the cornea. If the cornea were perfectly shaped, it would have a spherical round even shape, like a basketball. In eyes that have astigmatism, the cornea is typically curved more like an oblong, football-like shape, similar to the shape of the back of a teaspoon.

“Depending on the degree and orientation of the unequal curvatures, astigmatism can cause mild or even severe blurry vision,” explained Dr. Milstein. 

Patients with cataracts and who are in need of cataract surgery have three choices when considering how to correct their astigmatism. First, patients can simply choose to be dependent on wearing eyeglasses after cataract surgery in order to correct astigmatism. Second, if appropriate, some patients may opt to have an additional surgical procedure called Limbal Relaxing Incisions (LRI) or third, patients can elect have an astigmatism correcting toric lens implant in which the astigmatism correction is incorporated into the lens prescription just as in eyeglasses. “Toric lens implants are placed in the eye in exactly the same manner as ordinary lens implants at the time of cataract surgery and correct the astigmatism as part of the cataract surgery operation,” further explained Dr. Milstein.

If you or someone you know has cataracts or is considering cataract surgery, and has astigmatism please feel free to learn more about astigmatism correction after cataract surgery by calling  The Eye Clinic of Texas at 800-423-3937, visiting The Eye Clinic of Texas or facebook.com/ecot.lasik to schedule an appointment.

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology clinic in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City area that provides all aspects of general, medical, surgical, laser and optical eye care services. Our Board Certified Ophthalmologists perform Laser Eye Surgery such as LASIK, Cataract Surgery & Lens Implants using advanced technology IOLs to correct complex problems such as astigmatism and near vision focusing problems including presbyopia, diagnosis and management of glaucoma, diagnosis and management of diabetic retinopathy, diagnosis and management of Age Related Macular Degeneration (AMD) and Pediatric Ophthalmology. Texas EyeWear at The Eye Clinic of Texas provides personalized consultation and fitting of eyeglasses and eyeglass lenses for greater Houston, Galveston, League City and Texas City area patients.

Galveston & Houston eye doctor Dr. Da-Thuy Van commented on age related macular degeneration (AMD) treatment results and predictive factors for best success and outcome with Lucentis® injections. “Looking at the data from the long term clinical trials has shown that there can be considerable variability in patient responses to the Lucentis® injections we use to treat age related macular degeneration,” said Dr. Van of The Eye Clinic of Texas. “The good news is that thisinformation has been quite useful in establishing a number of diagnostic and treatment parameters that we use to optimize treatment and monitoring regimens to help patients get the best possible results,” Dr. Van explained.

Here are some important factors and considerations that we know today:

  • The initial visual acuity is not a good indicator for patients treated with monthly injections of Lucentis®. But, a poorer initial visual acuity seems to predict greater overall improvement.
  • Smaller areas of blood vessel growth seem to respond better to treatment.
  • If treatment begins BEFORE any hemorrhage has occurred there is usually a more favorable result.
  • The visual acuity found between the 3 and 5 month visit seems to predict about where the 12 month visit acuity will end up.
  • If there is a recurrence of subretinal fluid there is usually a negative effect on the long term visual recovery and functioning.

While there can be no guarantees, by using this information we can work to hopefully avoid the catastrophic vision loss from Wet Age Related Macular Degeneration (AMD).  YOUR role is to be consistent in scheduling routine eye exams if you are over 50 years old or even earlier if you have a family history of AMD-and should you notice symptoms including distortion of your vision, waviness or curving of lines or straight surfaces or a sudden change or spots of any kind, please call The Eye Clinic of Texas at 800-423-3937for an immediate appointment. The key to maintaining eye health and vision is early detection, diagnosis and treatment.

If you or someone you know has a family history of macular degeneration or is concerned about macular degeneration it is important to schedule regular eye exams by calling The Eye Clinic of Texas at 800-423-3937, visiting The Eye Clinic of Texas or facebook.com/ecot.lasik to schedule an appointment.

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology clinic in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City area that provides all aspects of general, medical, surgical, laser and optical eye care services. Our Board Certified Ophthalmologists perform Laser Eye Surgery such as LASIK, Cataract Surgery & Lens Implants using advanced technology IOLs to correct complex problems such as astigmatism and near vision focusing problems including presbyopia, diagnosis and management of glaucoma, diagnosis and management of diabetic retinopathy, diagnosis and management of Age Related Macular Degeneration (AMD) and Pediatric Ophthalmology. Texas EyeWear at The Eye Clinic of Texas provides personalized consultation and fitting of eyeglasses and eyeglass lenses for greater Houston, Galveston, League City and Texas City area patients.

“There is some important new research about risk factors for macular degeneration progression,” commented Ophthalmologist Allan Fradkin, M.D. of The Eye Clinic of Texas serving greater Houston & Galveston. “Data from a report published in Ophthalmology evaluated age, body mass index (BMI), smoking status, genetic variations, pre-existing retinal disease and drusen size to establish an algorithm for predicting the risk of patients in progressing to the move visually disabling advanced age related macular degeneration,” stated Dr. Fradkin. “What we now know for sure is that the increased risk of progression is correlated with age, lower educational level, being a current or former smoker and having a higher body mass index (BMI) than those who did not progress. This is helpful in how we counsel, evaluate and follow patients at risk for macular degeneration.”

If you are over 50 years old or even earlier if you have a family history of AMD or any of the risk factors mentioned, you should please call The Eye Clinic of Texas at 800-423-3937, visit The Eye Clinic of Texas or facebook.com/ecot.lasik to schedule an appointment.

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology clinic in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City area that provides all aspects of general, medical, surgical, laser and optical eye care services. Our Board Certified Ophthalmologists perform Laser Eye Surgery such as LASIK, Cataract Surgery & Lens Implants using advanced technology IOLs to correct complex problems such as astigmatism and near vision focusing problems including presbyopia, diagnosis and management of glaucoma, diagnosis and management of diabetic retinopathy, diagnosis and management of Age Related Macular Degeneration (AMD) and Pediatric Ophthalmology. Texas EyeWear at The Eye Clinic of Texas provides personalized consultation and fitting of eyeglasses and eyeglass lenses for greater Houston, Galveston, League City and Texas City area patients.

Dr. Da-Thuy Van
Dr. Da-Thuy Van

“As we enter the 2013 National Age Related Macular Degeneration (AMD) Awareness Month, we ask Houston patients to take a moment and consider how they can help preserve their eye health and vision with a better familiarity of AMD”, said Houston eye specialist Dr. Da-Thuy Van of The Clinic of Texas. It is estimated that more than 2 million people age 50 and older have late AMD (Age Related Macular Degeneration) which represents a 25 percent increase between 2000 and 2012.  “It’s not surprising that the number of people affected by macular degeneration continues to grow, especially due to the aging baby boomer population,” said Dr. Van.  “In the past, we were pretty much only able to give patients with Age Related Macular Degeneration (AMD) bad news about their vision and prognosis. Today, for most patients, with early detection, diagnosis and treatment, at a minimum we can prevent further vision loss from the disease and in many cases we can actually help recover lost vision,” she further explained.

What to Know About Age Related Macular Degeneration

AMD causes central vision to blur, but leaves peripheral vision intact. It is progressive and painless. There are two types of AMD, a “Dry” form and a “Wet” form. It is estimated that 85-90% of people with AMD have the Dry form which results in a gradual vision loss. Fortunately, only 10 percent of people with AMD have the Wet form which progresses much quicker and can cause catastrophic vision loss. Wet AMD is characterized by the growth of abnormal retinal blood vessels that leak blood or fluid. Leaking or bleeding vessels leads to swelling and bleeding in the Macula, causing visual distortions or decreased vision. Over time, this can lead to scarring in the Macula and create damage that may result in the loss of central vision. Patients can often reduce their risk of developing AMD by not smoking as well as working to eat a heart-healthy diet rich in fish, fruit and green leafy vegetables, avoiding foods with Trans fats, exercising and controlling blood pressure and weight.

“What patients need to be aware of is that once you are over 50, it becomes increasingly important to have a thorough, comprehensive dilated eye exam every one to two years-and even more often if you have any family history of AMD or at the recommendation of your eye doctor. The key to preventing vision loss from AMD is clearly early detection, quick diagnosis and then immediate access to treatment with vascular endothelial growth inhibitor (VEGF) injections such as Lucentis®.” summarized Dr. Van.

If you or someone you know would like to learn more about age related macular degeneration (AMD), please call The Eye Clinic of Texas at 800-423-3937, visit The Eye Clinic of Texas or facebook.com/ecot.lasik to schedule an appointment. 

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology group in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City area that provides all aspects of general, medical, surgical, laser and optical eye care services. Our Board Certified Ophthalmologists perform Laser Eye Surgery such as LASIK, Cataract Surgery & Lens Implants using advanced technology IOLs to correct complex problems such as astigmatism and near vision focusing problems including presbyopia, diagnosis and management of glaucoma, diagnosis and management of diabetic retinopathy, diagnosis and management of Age Related Macular Degeneration (AMD) and Pediatric Ophthalmology. Texas EyeWear at The Eye Clinic of Texas provides personalized consultation and fitting of eyeglasses and eyeglass lenses for greater Houston, Galveston, League City and Texas City area patients.

The Eye Clinic of Texas-a Houston Eye Associates affiliated practice-is pleased to announce that Drs. Bernard Milstein, Allan Fradkin and Da-Thuy Van have all been reviewed and elected by their peers as Best Doctors® for 2013, a group of clinically and academically accomplished doctors comprised of the top 5% of physicians in the U.S. In addition, Dr. Milstein has been recognized as a Texas Super Doctor® for 2013 for the 8th consecutive year and is the only ophthalmologist to be selected in Galveston County. 

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology group in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City area that provides all aspects of general, medical, surgical, laser and optical eye care services. Our Board Certified Ophthalmologists perform Laser Eye Surgery such as LASIK, Cataract Surgery & Lens Implants using advanced technology IOLs to correct complex problems such as astigmatism and near vision focusing problems including presbyopia, diagnosis and management of glaucoma, diagnosis and management of diabetic retinopathy, diagnosis and management of Age Related Macular Degeneration (AMD) and Pediatric Ophthalmology. Texas EyeWear at The Eye Clinic of Texas provides personalized consultation and fitting of eyeglasses and eyeglass lenses for greater Houston, Galveston, League City and Texas City area patients.

“Now is the time for patients who want LASIK in Houston to use any Flex Plan funds that might be available to them,” commented Amy Trittel, Refractive Surgery Coordinator at The Eye Clinic of Texas. “January is a popular month for New Year’s resolutions which often includes self improvements like LASIK. If you or a family member has Flex Plan funds to use, this is a good time to make LASIK affordable.” 

Many employers offer Flex Plans-Flexible Spending Accounts or FSA’s. These plans allow you to have money taken out of your paycheck over time to pay for LASIK. What is even more appealing about Flex Plans is that money is withheld in Pre-Tax dollars allowing you to get extra tax savings 

If you or someone you know would like to learn more about LASIK or schedule a Free LASIK Consultation, please call The Eye Clinic of Texas at 800-423-3937, visit The Eye Clinic of Texas or facebook.com/ecot.lasik to schedule an appointment.

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology clinic in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City area that provides all aspects of general, medical, surgical, laser and optical eye care services. Our Board Certified Ophthalmologists perform Laser Eye Surgery such as LASIK, Cataract Surgery & Lens Implants using advanced technology IOLs to correct complex problems such as astigmatism and near vision focusing problems including presbyopia, diagnosis and management of glaucoma, diagnosis and management of diabetic retinopathy, diagnosis and management of Age Related Macular Degeneration (AMD) and Pediatric Ophthalmology. Texas EyeWear at The Eye Clinic of Texas provides personalized consultation and fitting of eyeglasses and eyeglass lenses for greater Houston, Galveston, League City and Texas City area patients.

Galveston & Houston Ophthalmologists from The Eye Clinic of Texas reviewed what you should know about glaucoma eye exams and screenings. “Early detection, diagnosis and treatment are the keys to preventing vision loss from glaucoma. This is why proper glaucoma eye exams and screenings are so important-especially is any family member has a history of high eye pressure or a diagnosis of glaucoma,” commented Allan Fradkin, M.D.

“Eye exams for glaucoma should begin by checking your visual acuity with and without your eyeglasses or contact lenses. Then, the tonometry test should be performed. This is a method of measuring your Intraocular Pressure (IOP) and gives your eye doctor the first piece of important information in determining whether you might have glaucoma,” noted Ophthalmologist Dr. Da-Thuy Van. Ophthalmoscopy is another examination procedure used to detect and diagnose glaucoma. “Ophthalmoscopy is a method of carefully examining the inside of the eye-especially the optic nerve-in order to detect glaucoma. It is necessary to have some eye drops placed in your eyes in order to dilate your pupils so that we can make a clear and direct observation of the optic nerve,” explained Bernard Milstein, M.D. 

If either the Intraocular Pressure (IOP) is elevated or the optic nerve appears unusual, additional tests will be necessary in order to complete the glaucoma examination. These may include Visual Field Perimetry, Gonioscopy, Optic Nerve Computer Imaging and Pachymetry. Should you need any of these tests we explain them fully to you and answer your questions so that you understand how they allow us to diagnose glaucoma.

If you are under 40 years of age and do not have any family history of glaucoma or ocular hypertension-and have no other glaucoma risk factors such as high blood pressure or diabetes or being of African-American or Hispanic descent, then having a glaucoma eye examination every two years should be sufficient. If you have any glaucoma risk factors, a family history or are over 40-especially if you are of African-American or Hispanic descent, then a glaucoma eye exam each year is recommended.

If you or someone you know would like to learn more about glaucoma or schedule a glaucoma eye exam or screening please call The Eye Clinic of Texas at 800-423-3937, visit The Eye Clinic of Texas or facebook.com/ecot.lasik to schedule an appointment. 

The Eye Clinic of Texas is a leading eye care practice serving the greater Houston, Galveston, League City and Texas City area that provides all aspects of general, medical, surgical, laser and optical eye care services. Our Board Certified Ophthalmologists perform Laser Eye Surgery such as LASIK, Cataract Surgery & Lens Implants using advanced technology IOLs to correct complex problems such as astigmatism and near vision focusing problems including presbyopia, diagnosis and management of glaucoma, diagnosis and management of diabetic retinopathy, diagnosis and management of Age Related Macular Degeneration (AMD) and Pediatric Ophthalmology. Texas EyeWear at The Eye Clinic of Texas provides personalized consultation and fitting of eyeglasses and eyeglass lenses for greater Houston, Galveston, League City and Texas City area patients.

“Given the size and ethnic makeup of our Houston community, glaucoma eye exams and glaucoma screening need to be an important part of what we discuss with patients and their families,” commented Galveston & Houston Ophthalmologist Dr. Da-Thuy Van of The Eye Clinic of Texas. Prevent Blindness America has designated January as National Glaucoma Awareness Month. Patients should be particularly sensitive to the fact that in African-American and Hispanic populations, glaucoma is the leading cause of blindness. Additional glaucoma risk factors include any family history-especially among siblings-of glaucoma, certain diseases such as diabetes and an increase is risk as patients transcend through their 40’s, 50’s and 60’s. The most recent statistical data provided by Prevent Blindness America indicates that 2,719,379 people age 40 and older have open-angle glaucoma, which reflects a 22 percent increase over 2000-a 22% increase!

“The key step in preventing vision loss from glaucoma is early detection, diagnosis and treatment,” said Dr. Van. “This is why we want raise awareness about the importance of regular eye examinations to preserve vision especially for our aging population. We strongly recommend that siblings of glaucoma patients be screened each and every year as their risk of developing glaucoma is some 5 times higher than the typical population.”

If you or someone you know would like to learn more about glaucoma or schedule a glaucoma eye exam or screening please call The Eye Clinic of Texas at 800-423-3937, visit The Eye Clinic of Texas or facebook.com/ecot.lasik to schedule an appointment.

The Eye Clinic of Texas is a leading eye care practice serving the greater Houston, Galveston, League City and Texas City area that provides all aspects of general, medical, surgical, laser and optical eye care services. Our Board Certified Ophthalmologists perform Laser Eye Surgery such as LASIK, Cataract Surgery & Lens Implants using advanced technology IOLs to correct complex problems such as astigmatism and near vision focusing problems including presbyopia, diagnosis and management of glaucoma, diagnosis and management of diabetic retinopathy, diagnosis and management of Age Related Macular Degeneration (AMD) and Pediatric Ophthalmology. Texas EyeWear at The Eye Clinic of Texas provides personalized consultation and fitting of eyeglasses and eyeglass lenses for greater Houston, Galveston, League City and Texas City area patients.

“Fuch’s Dystrophy is a slowly progressive disease of the cornea that is typically bilateral and is slightly more common in women than men”, commented Galveston and Houston Ophthalmologist Bernard Milstein, M.D.  “While it is possible to observe Fuch’s Dystrophy in people in their 30’s and 40’s, it usually does not compromise vision until people are in their 50’s or 60’s.” While a precise path of genetic transmission is unclear, a familial predisposition seems to exist among those who are first degree relatives. Early in the course of Fuch’s Dystrophy patients typically awaken with blurry vision that gets progressively clearer as the day passes. This phenomenon occurs because the cornea normally swells during sleep.  

A healthy endothelial pump is necessary in order to restore the cornea to a normal thickness. In Fuch’s Dystrophy, the endothelium removes fluid from the cornea less efficiently.  As the Fuch’s Dystrophy disease worsens, the vision does not clear. Usually we will attempt to help reduce the corneal swelling each day by prescribing hypertonic eye drops and ointments. However, when these measures fail to provide comfort and clear vision, it may be necessary to have a corneal transplant. In general, corneal transplantation is used in order to replace diseased, damaged or scarred corneal tissue with new healthy corneal tissue. Since damaged or scarred corneal tissue impairs effective passage of light into the eye and may distort or degrade the quality of images that reach the retina, poor vision and even blindness may result from a damaged cornea. There are actually a number of different types of corneal transplants that we can consider for Fuch’s Dystrophy.  

If you or someone you know would like to learn more about Fuch’s dystrophy please call The Eye Clinic of Texas at 800-423-3937, visit The Eye Clinic of Texasor facebook.com/ecot.lasik to schedule an appointment.

The Eye Clinic of Texas is a leading eye care practice serving the greater Houston, Galveston, League City and Texas City area that provides all aspects of general, medical, surgical, laser and optical eye care services. Our Board Certified Ophthalmologists perform Laser Eye Surgery such as LASIK, Cataract Surgery & Lens Implants using advanced technology IOLs to correct complex problems such as astigmatism and near vision focusing problems including presbyopia, diagnosis and management of glaucoma, diagnosis and management of diabetic retinopathy, diagnosis and management of Age Related Macular Degeneration (AMD) and Pediatric Ophthalmology. Texas EyeWear at The Eye Clinic of Texas provides personalized consultation and fitting of eyeglasses and eyeglass lenses for greater Houston, Galveston, League City and Texas City area patients.

“Not all generic medications or eye drops are created equal!” affirmed greater Houston Ophthalmologist Bernard Milstein, M.D. of The Eye Clinic of Texas.  We are constantly using brand medications to treat many eye conditions. Many times the brand becomes synonymous with the agent that treats it.  That is called branding. In the past when we had few options in the way of medications to treat conditions, the climate was better for such branding. Today, pharmaceuticals have patents on their products. These patents have a certain duration. Once the patent expires, any company that has the ability can create a similar medication. Herein lies the big dilemma! For years you have been using brand X and getting the results your physician wants for you. Now the medication is available as a generic. The use is the same, you are familiar with the indications, dosage, and the price might be less expensive. This is a very big drawing point-you are saving money, while getting the same result. Sounds like a winner! But is it?

Not all generic medications are the same as the brand name. Yes, they have the same active ingredient, but they might have different preservatives and other substances that might not make them work as well for you. What can you do when the pharmacist gives you a generic other than the brand name?  If your Ophthalmologist hasn’t informed you that there is a possibility that your next prescription will be filled with a generic, take the bottle in to the next visit. It is likely that you will have a follow up visit at a closer interval to access efficacy.  Once he or she is sure that the medication does not have any ingredients that might not suit you and that the effect is the same, you will return on regular intervals. When in doubt ask questions, describe any symptoms that are unusual. It is important to you and your doctor to know about any changes in medication. Remember, just because it is less expensive it doesn’t mean that it is better, or not as good.

If you or someone you know would like to learn more about generic eye medications please call The Eye Clinic of Texas at 800-423-3937, visit The Eye Clinic of Texasor facebook.com/ecot.lasik to schedule an appointment.

The Eye Clinic of Texas is a leading eye care practice serving the greater Houston, Galveston, League City and Texas City area that provides all aspects of general, medical, surgical, laser and optical eye care services. Our Board Certified Ophthalmologists perform Laser Eye Surgery such as LASIK, Cataract Surgery & Lens Implants using advanced technology IOLs to correct complex problems such as astigmatism and near vision focusing problems including presbyopia, diagnosis and management of glaucoma, diagnosis and management of diabetic retinopathy, diagnosis and management of Age Related Macular Degeneration (AMD) and Pediatric Ophthalmology. Texas EyeWear at The Eye Clinic of Texas provides personalized consultation and fitting of eyeglasses and eyeglass lenses for greater Houston, Galveston, League City and Texas City area patients.